Organization
NORTHEAST MISSOURI HEALTH COUNCIL INC
Active
Other names
Northeast Family Health
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW H GRIMM (EXECUTIVE DIRECTOR)
(660) 627-5757
Entity
Organization
Contact information
Practice address
1506 CROWN DRIVE, KIRKSVILLE, MO 63501
(660) 627-4493
(660) 627-4288
Mailing address
1416 CROWN DRIVE, KIRKSVILLE, MO 63501-2548
(660) 627-5757
(660) 627-5802
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
002241
MO
1041C0700X
Clinical Social Worker
2005037424
MO
1041C0700X
Clinical Social Worker
2006005622
MO
207Q00000X
Family Medicine Physician
111208
MO
207Q00000X
Family Medicine Physician
R5E64
MO
207Q00000X
Family Medicine Physician
R5N07
MO
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MO
363LF0000X
Family Nurse Practitioner
096968
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
503351843
—
MO
Enumeration date
01/29/2007
Last updated
06/24/2011
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